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Whole-breast irradiation after lumpectomy may protect women from recurrence long term

SALT LAKE CITY, UTAH--A Fox Chase Cancer Center study of more than 2,700 women with breast cancer who received whole-breast irradiation following lumpectomy identifies a clear benefit that may not be gained with partial breast irradiation. Gary Freedman, M.D., a radiation oncologist at Fox Chase Cancer Center in Philadelphia, Pa., presented the study today at the 45th annual scientific meeting of the American Society of Therapeutic Radiology and Oncology on October 21st in Salt Lake City, Utah. After lumpectomy, the rationale for treating the whole breast with radiation has been the risk of having microscopic tumor cells in other parts of the breast. A majority of cancer recurrences in the breast after lumpectomy with whole-breast irradiation have been reported to occur within the same area of the breast as the initial primary tumor.

There also has been recent interest in treating with focal radiation only the part of the breast containing the primary tumor. This raises the question of how much the standard whole-breast radiation is reducing the risk of recurrence in other parts of the breast. Freedman and his colleagues looked at the overall risk of recurrence after breast-conserving surgery and whole-breast radiation. They also subdivided these into recurrences near the original primary tumor and elsewhere in the treated breast.

By 15 years after treatment, the risk of true local recurrences was 9%. The risk of recurrence in other parts of the breast within 10 years was very low, as had been suggested by prior studies, but by 15 years it was nearly equal to the risk of recurrence in the original breast quadrant.

"While this may seem to support a favorable outcome for replacing whole-breast irradiation with partial-breast irradiation, our study shows a dramatic shift in the location of recurrence between 10 and 15 years after treatment," said Gary M. Freedman, M.D., lead author of the study.

The researchers compared the risk of recurre
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Contact: Karen Carter Mallet
k_carter@fccc.edu
215-728-2700
Fox Chase Cancer Center
21-Oct-2003


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